| NPI | 1679115588 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: NY 785742971) |
| Additional Taxonomies | 174400000X Specialist (Licence: NY 812557981) |
| Enumeration Date | 2019-10-11 |
| Last Update Date | 2019-10-11 |